超前镇痛管理对非小细胞肺癌患者围手术期免疫功能、预后的影响分析

doi:10.3969/j.issn.1671-7171.2017.05.013

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨超前镇痛管理对非小细胞肺癌(NSCLC)患者围手术期免疫功能、预后的影响。方法将本院在2015年1月至2016年7月收治的NSCLC患者115例,按照随机、双盲的分配原则分为观察组58例和对照组57例。观察组采用超前镇痛管理,对照组采用常规镇痛模式。观察两组不同镇痛管理对围手术期免疫功能、预后的影响。结果观察组术后6 h、1 d、3 d的视觉模拟评分法(VAS)均明显低于对照组,其差异均有统计学意义(P<0.05);两组患者术前CD4⁺与CD8⁺水平比较差异无统计学意义(P>0.05),而术后均有不同程度下降,且明显低于术前,但观察组仍高于对照组,其差异均有统计学意义(P<0.05)。观察组首次下床时间为(2.72±0.92)d,发生肺部感染、肺不张、胸腔积液分别为3.45%、0.00%、0.00%,均明显少于对照组,其差异有统计学意义(P<0.05)。结论超前镇痛管理可更有效的减轻NSCLC患者围手术期的疼痛,并保护免疫功能,改善其预后,值得临床推广应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：镇痛, 癌, 非小细胞肺/外科学, 癌, 非小细胞肺/免疫学, 手术期间, 预后

Abstract： Objective To explore effect of preemptive analgesia management on perioperative immune function and prognosis of patients with non-small cell lung cancer. Methods All patients were divided into experimental group (n=58) and control group (n=57) according to the principle of randomized, double-blinded assignment of 115 cases of non-small cell lung cancer admitted in our hospital from January 2015 to July 2016. Preemptive analgesia was used in the experimental group and conventional analgesia was used in the control group. Our goal was to observe the effect of different analgesia management on perioperative immune function and prognosis. Results The visual simulation scores (VAS) of the two groups were observed 6h, 1d, 3d after operation. The score of the experimental group was significantly lower than that of the control group (P<0.05). There was no significant difference in CD4⁺ and CD8⁺ levels between the two groups before operation (P>0.05). The levels of CD4⁺ and CD8⁺ in the two groups after surgery were significantly lower than those before operation, but the CD4⁺ and CD8⁺ levels in the experimental group were still higher than those in the control group, and the difference was statistically significant (P<0.05). The first time that patient got out the bed for activities in the experimental group was (2.72 ± 0.92) d,and the rate of lung infection, atelectasis, pleural effusion were 3.45 %, 0.00 %, 0.00 %, respectively, all significantly less than the control group (P<0.05). Conclusion Preemptive analgesia management can more effectively reduce the perioperative pain in patients with non-small cell lung cancer, protect the immune function, and improve the prognosis of postoperative effect. It is worth promoting.

Key words： Analgesia Carcinoma, Non-Small-Cell Lung/SU Carcinoma, Non-Small-Cell Lung/IM Intraoperative Period Prognosis

收稿日期: 2016-05-04

PACS:

引用本文:

刘高琼,吴丹,陶红,曾玉婷,许新春. 超前镇痛管理对非小细胞肺癌患者围手术期免疫功能、预后的影响分析[J]. 医学临床研究, 2017, 34(5): 872-875,878.
LIU Gao-qiong, WU Dan, TAO Hong, et al. Effect of Preemptive Analgesia Management on Perioperative Immune Function and Prognosis of Patients with Non-Small Cell Lung Cancer. JOURNAL OF CLINICAL RESEARCH, 2017, 34(5): 872-875,878.

链接本文:

http://www.jcr.net.cn/CN/10.3969/j.issn.1671-7171.2017.05.013 或 http://www.jcr.net.cn/CN/Y2017/V34/I5/872

[1] 刘倩汝.地佐辛治疗肺癌术后疼痛的疗效及安全性研究[J].临床合理用药杂志,2016,9(3):87-88.
[2] 易晓青,刘鸿芹,屠奕,等.超前镇痛对肺癌根治术后患者有效呼吸影响的观察[J].护理与康复,2012,11(8):765-766.
[3] 周章,宋俊,阮云丹,等.超前镇痛应用于肺部手术患者对其术后疼痛以及炎性因子的影响探讨[J].临床肺科杂志,2016,21(7):1321-1324.
[4] 庄海滨,许福生.双侧胸椎旁神经阻滞对肺癌根治术患者术后镇痛效果影响[J].临床军医杂志,2016,12(1):85-88.
[5] 毕艳,肖交华,张博卿,等.右美托咪定联合氟比洛芬酯用于肺癌根治术超前镇痛的效果观察[J].现代诊断与治疗,2016,27(15):2799-2800.
[6] Song J , Li L , Yu P .Preemptive scalp infiltration with 0.5% ropivacaine and 1% lidocaine reduces postoperative pain after craniotomy[J].Acta Neurochir (Wien),2015 ,157 (6): 993-998.
[7] 孙立新,张彦平,侯念果,等.帕瑞昔布钠对肺癌根治术患者术后镇痛的影响[J].临床麻醉学杂志,2012,28(12):1204-1206.
[8] 梅忆枫,翟志娟.帕瑞昔布钠对肺癌根治术患者术后镇痛的影响[J].吉林医学,2015,12(8):1510-1512.
[9] 王渊,石源,尹卓伟,等.持续输注右美托咪啶对肺癌根治术患者肺功能及苏醒质量的影响[J].中华肺部疾病杂志(电子版),2015,8(5):56-59.
[10] Lu J , Liu Z , Xia K , Effect of preemptive analgesia with parecoxib sodium in patients undergoing radical resection of lung cancer[J].Int J Clin Exp Med,2015 ,8 (8): 14115-14118.
[11] 王瑞枝,杜雪江.硬膜外阻滞联合全身麻醉对肺癌根治术患者细胞免疫功能的影响[J].标记免疫分析与临床,2016,23(11):1288-1290.
[12] 阿不都海力,阿地里江,塔依尔,等.曲马多与舒芬太尼治疗瑞芬太尼复合麻醉术后急性疼痛的效果分析[J].转化医学电子杂志,2015,2(9):126-127.
[13] 诸葛晓红,严小俊.社区家庭病床晚期癌痛患者使用镇痛泵的临床观察[J].转化医学电子杂志,2015,2(11):32-34.
[14] Wang LD , Gao X , Li JY , Effects of preemptive analgesia with parecoxib sodium on haemodynamics and plasma stress hormones in surgical patients with thyroid carcinoma[J].Asian Pac J Cancer Prev, 2015 ,16 (9): 3977-3980.
[15] 丁明霞,张兴梅.右美托咪定联合氟比洛芬酯用于肺癌根治术患者超前镇痛的效果观察[J].中华肺部疾病杂志(电子版),2015,8(5):68-70.
[16] 丁明霞,张兴梅.右美托咪定联合氟比洛芬酯用于肺癌根治术患者超前镇痛的效果观察[J].山西医药杂志,2015,16(18):2157-2159.
[17] 尹玲,罗五春.超前镇痛在肺癌患者术后呼吸道护理中的应用[J].海南医学,2011,22(24):136-137.
[18] 陆海波,陈默,司波等.多模式镇痛对肺癌根治术患者术后疼痛和免疫功能的影响[J].中国临床研究,2015,28(11):1493-1495.
[19] 黄礼兵,徐钢,杨光,等.帕瑞昔布钠超前镇痛对肿瘤术后淋巴细胞亚群的影响[J].实用药物与临床,2012,15(2):73-74.
[20] Huang J , Wang X . Preemptive analgesia with bupivacaine in reduction mammaplasty: a prospective, randomized, double-blind, placebo-controlled trial[J].Plast Reconstr Surg,2015,135 (6): 1062.
[21] 陈忠华,蒋宗明,郑羡河,等.硬膜外超前镇痛对肺癌根治术患者围术期Th1/Th2平衡的影响[J].河北医科大学学报,2011,32(1):52-55.
[22] 费海涛,顾成永.地佐辛联合地塞米松超前镇痛用于肺癌根治术患者的效果观察[J].临床肺科杂志,2014,14(11):2107-2109.